Body Image After Miscarriage and Infertility: How To Recover

The worst moment of my life came at approximately 1:30 PM on July 10, 2023, when I realized my baby was dead. I was lying in the ultrasound room, holding my husband’s hand. We were staring at the large projector screen, showing the inside of my uterus. At our last appointment, we got to joyfully glimpse our little one (named Forrest) moving around, and hear the miraculous sound of her heartbeat. But that day, at 14 weeks pregnant, there was only silence. It was a type of silence that I had never experienced before—a type that made me feel like I was dead, and more alone than I’ve ever felt in my 35 years of living. After sitting in that terrible silence for what felt like eons, I had to break it. “Is everything okay?” I asked. The question feels ridiculous now, but at the time, part of me could not accept reality even when it was staring me in the face. My midwife responded with the worst words ever spoken to me: “No. I’m sorry, but your baby doesn’t seem to be alive anymore.” I had a silent miscarriage (also called a “missed” miscarriage), which is when a baby dies in the womb without any of the typical symptoms of miscarrying like cramps and bleeding. My body still acted and felt as if I was pregnant, making the news all the more shocking and devastating. Like many miscarriages, ours was unexplained—and we were told it was simply bad luck. After my miscarriage, I felt completely betrayed by my body, and like all the trust I’d built with it was broken. My husband and I spent the rest of the week figuring out with our health-care providers how the pregnancy would end and how Forrest’s body would leave my body. It’s impossible to express exactly how I felt in the following moments, days, and months, but it was something like being stuck in a nightmare with absolutely no sign of waking up from it. I went from being shocked to infuriated to scared, and then headfirst into grief, which I am still processing now. Related Stories There is, of course, no possible way to prepare yourself for a miscarriage. But what most surprised me in the aftermath was how much I struggled to reconnect with my body. After years of neglecting my body through under-eating and over-exercising, I spent a lot of time as a young woman making peace with my body and learning how to befriend it. A large part of my life’s work as a dietitian has been devoted to helping others to heal from their own eating disorders and re-establish trust and acceptance with their bodies. But my miscarriage was foreign territory, and I found myself having consistent difficult thoughts and feelings toward my body for the first time in many years. I felt completely betrayed by my body and like all the trust I’d built with it was broken. Throughout my life, I’ve heard about women struggling with their changing bodies in pregnancy, but never about how miscarriage or infertility impact body image. I can’t help but wonder if this is because those topics are still so culturally taboo that they’re discussed way less than pregnancy in general. There’s also significantly less research surrounding body image changes during these life phases compared to body image in healthy, full-term pregnancies. But the silence on this topic does a disservice to the many of us who experience infertility and pregnancy loss. Ten to 20 out of 100 known pregnancies, or 10 to 20 percent, end in miscarriage. About one in five women in the U.S. experience infertility. I know several women who’ve experienced both. These experiences happen within our bodies, so of course they are going to impact how we feel about our bodies. Yet many of us aren’t prepared to navigate those feelings on top of everything else. How miscarriage can impact a woman’s relationship to her body After my loss, I felt like a stranger in my own body. I was scared of being alone with it—even on my yoga mat, which had been my safe place for over 15 years. I felt like my body failed me. I no longer viewed it as strong and powerful, but instead as disappointing and deeply flawed. My body had taken life from me, along with hopes, dreams, excitement, and innocence. I saw it as the former, empty home of my daughter and wasn’t sure I could ever trust it again. Many people who miscarry grapple with similar feelings. “In my personal experience, I struggled to trust my body after my first of two miscarriages because I felt broken and angry that my body couldn’t work ‘correctly,’” says Arden Cartrette, founder of The Miscarriage Doula + Co. A small 2022 study in the journal Healthcare found that women who went through late pregnancy loss (after 10-14 weeks of gestation, just like me) described feeling disassociation, a loss of control over the body, and emotions like betrayal, distrust, and anger towards the body. “Both women and fetuses were described as hostages of the body,” the study authors wrote. All the embodiment work I’d done to be in sync with my body in my recovery seemed pointless, since it hadn’t communicated a thing to me about my baby dying. The body changes I’d experienced so far, like bigger boobs and a bit of a growing belly, were also disorienting, a constant reminder my baby was gone. “I struggled with my own body image as people continued to ask if I was pregnant while I held onto the ‘pregnancy weight,’” shares women’s health dietitian Jamie Adams, RDN, RPYT, who also had a missed miscarriage. Despite being 10 years in recovery from my eating disorder, I also started to notice eating disorder thoughts popping up. This wasn’t necessarily a surprise to me, as I was in serious emotional pain and my old go-to was controlling my food and exercise. I was able to let the thoughts pass with the help of the tools and coping mechanisms I’d gained in recovery. But the fact that they came up at all made me feel like a fraud. I’d spent years healing my relationships to food, body, and exercise, and getting my health to a place where I could have children, and it felt like all that was a waste. All the embodiment work I’d done to be in sync with my body in my recovery seemed pointless, since it hadn’t communicated a thing to me about my baby dying. In my work as a dietitian, I see a clear connection between mental health struggles like anxiety, depression, and emotional distress—all of which happen at higher rates to women who have miscarried2 than those who haven’t—and worsened body image. A feeling like sadness, for example, may get funneled into negative body thoughts because it feels easier to bash your body instead of feeling and processing the sadness. That’s certainly how things played out for me after my own pregnancy loss. The toll of infertility on body trust Like miscarriage, infertility can significantly impact a woman’s relationship to her body. Cartrette says she struggles with resentment towards her body, and sees it in some of her clients, too. “I don’t ovulate on my own, which has always impacted my relationship with my body because I can’t have a spontaneous pregnancy, there are no surprises for my husband or myself, and we must spend a lot of money to get pregnant in the first place,” she says. There’s also research showing high levels of infertility-related stress are linked to poorer body image3. “There are so many things that have to be ‘right’ for a pregnancy to occur and for that pregnancy to equal a healthy, living child, and when it’s not happening but a woman sees friends, family, and coworkers growing their family seemingly without a problem, it can make her feel like something is wrong with her,” explains Cartrette. “The more we feel disconnected with our bodies, the more blame we might place on them, but this can also lead to a disconnect in future cycles and pregnancies.” Adams says that some fertility treatments and hormonal medications can cause appearance and body changes and weight fluctuations, which is a struggle for many of her clients. Plus, research shows infertility can negatively…